Permit CITY TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00344
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/13/2007
PARCEL: 2S 110AC -02100
SITE ADDRESS: 11492 SW LAUREL GLEN CT ZONING: R -4.5
SUBDIVISION: LAUREL GLEN LOT: 004 JURISDICTION: TIG
PROJECT: DUNCAN
Project Description: Install a /c.
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
GAS OUTLETS:
> 10000 cfm:
Owner: FEES
LLOYD DUNCAN Description Date Amount
11492 SW LAUREL GLEN CT
TIGARD, OR 97224 [MECH] Permit Fee 6/13/20W $72.50
[TAX] 8% State Surchart 6/13/20W $5.80
Total $78.30
Phone: 503 - 348 -9855
Contractor:
TRI COUNTY TEMP CONTROL
13150 S. CLACKAMAS RIVER DR
OREGON CITY, OR 97045 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -557 -2220
FAX 503 -557 -0919
Reg #: LIC 72623
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws.
All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is
suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center.
Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC by
calling 503.246.6699 or 1.800.332.2344.
` , Permittee Si natu _ / A.4J t
Call 503.639.4175 by 7:00 a.m. for inspections that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
. ,,JUN;:12 -2007 03:31P FROM: TO:50359819E0 P.1
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Mechanical Permit Aonlication
• Fog OFFICE USE ONLY q.,
City of Tigard Received
13125 5W Hall Blvd., Tigard, OR 97223
Phone: 503.639.4171 Fax: 503.598.1960 Date/By: I 7 7/g Permit M e . a ?i� .
r . Plan Review Other Permit:
sp �® '/a '�.' ' o' + `I, Dare/By:
Inspection Line: 503.639.4175 _.i j, 1 Date Read iB
Interact Www.ci.tigard,or.us --� Ready /By: El See Page Z for
JUN 1 2 I I Notified/Method: Supplemental Information
f -A7 �'ik e re '1ua. .... W! ' ice. , r _,.
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� t - DIVISIO Mechanical permit fees" are based on the value of the work `' :, -:.. : . ,�: �',_ :',T..7.- �sps�c�ezc>~rs�r
r'• L r.
❑ New construction Addiho a eratioi>/rep acement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other:
mechanical materials, equipment, labor, overhead, and profit
K "4 .Ny», E,,,�Ym.et w::4 #+. y,r °r..,: r. u t , x } .
ti ' p [li -O'i` CiY :06,1T'S `Cieettf Tt ` tv : 1 ( .,r ..-- V a l
fir. -�l.Y 9ifY ►a. ti�.�.� r. - � .... • ,rr . �+.te � r : W � n .r" , '� ; ..i .''� :r � . -�. - i . .: .. ... ue: $
dwelling �rl SD?Nr� ',S2N1EH^' /' 'SYST
I- and 2-family
For special information use checklist.
'` Y g ❑ C aster builder stria! ❑ Accessory building
U Multi- family Y ❑Master builder ❑Other: Description Ea. Total
P 'i
,t,.'.0t�'Njr , ''?riUB l ~ i zT r�, i,. i . : / pri _ i 'r. . ..
=,-,i - ri = ., l'1yA[7O , , . ..,= t faw," , „ - ., ..
»w � ,L k : H eaHnttJcooling
Job sire address• I I4�2. ew ! i U ('.� ( Air conditioning or heat pump y
�U (requires site plan showing placement) ( 14.00
City/ State/ZIP: 1i(�(�r (7224 Furnace 100,000 BTU (ducts/vents) 14.00
�" Furnace 100,000+ BTU ducts /vents) 17.90
Suite/bldg. /apt. no.: I Project name; 1 •
Gas heat pump 14.00
Cross sneer/directions to job site: Duct work 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
. Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Subdivision I Lot no.: Flue/vent for any of above 10.00
Other: 10.00 .
Tax map /parcel no.: Other fuel appliances _
_V4 ' ass, . _ ,�y: � '' :;ak- : 1 ': -, Water heater t. rn �.4:,: ,. ,:.. DECRIP , , ,'; - 5! ORi4 , - n j i,, I . 10.00
,- ,
:fi � 4'. �'x' _ u , . � +,ys w�* " ° � +g.c�.. 'el•
Gas fireplace 10.00
� Flue vent for water heater or gas
ire/in fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
t ' ' .. _ . ,... - _ _ T . T- , - .... -. - „ .� . :... ,,: _ Chimney /liner /flue /vent 10.00
C 4t` . !lt 491 ! • n Q. i i7lIt + TUt : ,'- ft i ti".. ElYA1V. �- ;� r . '
, >,. ,,. s ,u . ,».. +�'.> :a"�' �> . c .�a+t�ru;`'.. r.:la� "n�l^nr: "i Other 10.00
Name: I to a) Environmental exhaust and ventilation
Address: V Range hood /other kitchen
equipment 10.00
City/State/ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) -cr0 / Fax' ( ) toilet compartments, utility rooms) 6.80
�`..y; ®` APP z.,"_;'y %,tyryg_' ,..+ ,' .. » , Attic /craw fans 10.00
:.srv:••, dr 1... e l;:.. TT''.. ; 444, -, vfi! is GO 0'1~4 o- 12 }1 ,
T n CCW L I i T Co Other: 10.00
Business game: 1 r(� � rrtto (J i
Fuel piping
Contact name: - 1 iV m�50n $5.40 for first four; S1.00 for each additional
Address: l' BO 0 n I QC kn i S (J / r] Furnace, etc.
`�- �l -N '`i^' ` R . 617 Gas suspe rap
Ciry /Statd �al�,�'1 ZIl': e WaiVsusptnded/unitbeater
Phone: () 557/ --1, '7C I Fax:: ( ) 357-0q q Water heater
Fireplace
E -mail: Ran
""-t • �... ; - � v 1 Be • t , fir- '' ' , 1 : ; % °Ga ' '` , q �'°. 1. 1 1 C. �;� ' . l ' : .: ,; Barbecue
Business name: Temp T r 1 C C L Tel tp ("C) o! Clothes dryer (gas)
Other:
Address: t ?) (50 g. � � Ka e�tri V � $ : .
ry m�• V -. i- Fri :V
City/State/ZIP: OY 6f. Qk- `mil Subtotal
Phone: (503) 55 -222h ` Fax: (6Q 557 l'/ Minimum permit fee ($72.50)
Plan review (25% of permit fe ) • B
CCB lie.: 7G-10 State surcharge (8% of permit fe is✓v
• Q TOTAL PERMIT F
Authorized signature: h ' L ,6740.0-x permit application expires it a permit Is not o a
days after It has been accepted au complete.
Print name: a j Le A4/4564 Date: 1,Q1(4I * Fee methodology set by Tri -County Building Industry Service Board
mnuild n,nPemvuON$C- PemdiAeadnc 12/03 440- -4617T (11 /O7JCOM/W813)
.. JUN ±2-2007 03:31P FROM: TO: 5035981960 P.2
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~°~~"~~~°."°~= ~�"°"~~"~~"° - PERMIT #: MEC2007-00344
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6813/2007
Phone: (5O3)G39'4171 .
Inspection Requests (24Hm.):(503)63g'4175 ,......._w "���
INSPECTION WORKSHEET FOR DATE: 7Y11/2007 TIME: 7:01A1v8 PAGE: 39
.
SITE ADDRESS: 11492 SW LAUREL GLEN CT CLASS OF WORK:
SUBDIVISION: LAUREL GLEN LOT #: 004 TYPE OF USE:
PROJECT NAME: DUNCAN
DESCRIPTION: Instm|alc.
OWNER: DUNCAN, LLOYD PHONE #: 503-348-9855
CONTRACTOR: TRI COUNTY TEMP CONTROL PHONE #: 503- 577- 2 O
Inspection Request Scheduled For: Date: 7g11/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 05180?-01 503-557-2220 Y
Corrections/Comments/Instructions:
(5 67-"1".11
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•
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_ PARTIAL A[��R{�/AL u CANCEL '_- __LNCLAC.CESG-- - _____ .
| I FAIL I | CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: / Al - . Date: / Phone #: 85O3>718-
` .
. . .